thiotepa + busulfan + cyclophosphamide

A high-dose, multi-agent chemotherapy conditioning regimen composed of the alkylating agents thiotepa, busulfan, and cyclophosphamide, most commonly used before autologous hematopoietic stem cell transplantation for primary or secondary central nervous system lymphoma. Mechanistically, each component is a DNA-alkylating small molecule that causes DNA crosslinks and strand breaks, producing profound myeloablation and antitumor cytotoxicity. Clinical studies and practice reports show TBC can induce durable remissions in chemosensitive PCNSL but is associated with substantial toxicity and treatment-related mortality, particularly in older patients; 2-year PFS around 63–65% has been reported in selected cohorts, with treatment-related mortality ranging from approximately 11% to over 20% depending on population and center. Typical dosing in reports includes thiotepa 250 mg/m2/day on days −9 to −7, busulfan totaling 10 mg/kg orally or 8 mg/kg intravenously on days −6 to −4 (with dose reductions in older patients), and cyclophosphamide 60 mg/kg/day on days −3 to −2, followed by stem cell infusion on day 0. TBC is one of the most used thiotepa-based CNS lymphoma conditioning backbones, alongside thiotepa–BCNU combinations. [1][2][3][4]

Other names

TBCthiotepa busulfan cyclophosphamide